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TATA AIG HEALTH INSURANCE

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Tata AIG Health Insurance

Overview
Tata AIG General Insurance Company Limited is a joint venture between Tata Group and American International Group (AIG). Formed on January 22, 2001, the insurer completed 15 years of its India business operations in 2015. With an asset base of approximate 0.6 billion USD, a workforce of 2523 employees and 9446 agents and a presence in 98 locations across India, TATA AIG is today one of the most well known private general insurance companies in India. With a vision to be India's most preferred General Insurance Company, TATA AIG basis its customer service operations on 6 of its core values of Performance, Customer First, Integrity, People, Passion, and Empathy.

Tata AIG Health Insurance at a Glance
  • Timely Settlement of Claims with 3000+ Network hospitals across India.
  • An asset base of approximate 0.6 billion USD, a workforce of 2523 employees and 9446 agents.
  • Presence in over 98 locations across India.
  • Cashless claim approvals in 4 hours.
  • Exclusive Insurance Offers For HNIs
  • A wide range of health insurance plans covering the needs of everyone from individuals, families, senior citizens, executives and critically ill patients.
  • A 24/7 customer helpline is available for any assistance and queries on claim settlement.
  • Exclusive Wellsurance plans offering additional benefits including exclusive helpline for health and wellness information, a health portal, health query services, discounts with gyms and diagnostic centres.

Awards & Recognitions
  • As an industry first, Tata AIG has launched Young Achievers Programme, a one year post graduation diploma in General Insurance in association with Manipal Global Education.
  • Recognized at the Fintelekt Insurance Awards 2017 as the General Insurance Company of the Year in the small and medium category for displaying the fastest premium and policy growth rates in the financial year 2016-17.
  • Tata AIG General Insurance Company partners with Rubique in April 2017 for general insurance product offerings
  • Conferred with 'iAAA' rating for their Claims Paying Ability by the rating agency ICRA.

Documents needed to apply for Tata AIG Health Insurance
  • Age proof - (Any One)
    Driving License, Passport, Voter ID Card, Birth Certificate, etc
  • Identity proof – (Any One)
    Driving License, Passport, Voter ID card, PAN Card, Aadhar Card, or any document which proves citizenship
  • Income proof
  • Address proof – (Any One)
    Driving License, Passport and Utility Bill should clearly mention the permanent address
  • Income proof – (Any One)
    Salary Slip, Form 16, ITR
  • Recent passport size photograph

Why Tata AIG Health Insurance?
Here are some reasons why Tata AIG is the right insurance provider for you:

Features Description
Sum Insured Inpatient coverage up to 100% of sum insured and outpatient treatment up to Rs. 5,000 per policy year
Cashless hospitalisation A strong network of 3000+ hospitals across India offering cashless treatment for the insured.
Claim process Specified Third Party Administrator (TPA) licensed by IRDA of India will process all claims on behalf of Tata-AIG General Company Limited. The final decision on any claim solely rests with Tata-AIG General Insurance Company Limited.
Discounts 
  • Optional two years term available. The longer term option of two years policy is more convenient and economical as it comes with a discount on the premium.
  • Family Discount of 10% if 3 or more family members are covered under MediPrime Individual policy.
Portability The plans offered by Tata AIG health insurance can be ported from one insurer to another without losing the benefits like waiting period and no-claim bonus.
Day Care Treatment Day-Care procedures covered with Medical Expenses for enlisted 140 Day care procedures
Out Patient and Alternative Treatment reimbursements Ayush Benefit available with reimbursement of medical expenses incurred for In-patient treatment taken under Ayurveda, Unani, Sidha or Homeopath up to Rs. 20,000 for sum insured from 2lacs to 4lacs and up to Rs. 25,000 for sum insured from 5 lacs to 10 lacs per policy year.
Healthy Rewards Exclusive Wellsurance plans offering additional benefits including exclusive helpline for health and wellness information, a health portal, health query services, discounts with gyms and diagnostic centres.
Cancellation Policies would be cancelled by us on grounds of misrepresentation, fraud, and non-disclosure of material facts or non-cooperation by any Insured Person, upon giving 30 days notice. No refund of premium allowed if policy is cancelled on the grounds of misrepresentation, fraud, or non-disclosure of material facts.
Domiciliary Treatment Tata AIG health insurance policies cover for the medical expenses incurred for availing medical treatment at home on the advice of the attending Medical Practitioner which would otherwise have required Hospitalisation.
Grace Period A grace period of 30 days is available for all plans after the expiry date of a policy to renew the same.

Types of Tata AIG Health Insurance Plans
Tata AIG Health Insurance offers a range of affordable health insurance plans that are suitable to offer optimal protection for individuals, families, women and senior citizens. The various types of health insurance plans currently being offered by Tata AIG Health Insurance are as follows:

1: MediPrime: This a cashless health insurance offering cover for both pre and post hospitalization incurred up to 30 days immediately before hospitalization and up to 60 days immediately post hospitalization. The plan comes with a tax saving component as well as a no co-payment clause.

2: Wellsurance Executive: Wellsurance Executive is a unique combination of health insurance and wellness program. The policy provides coverage for critical illnesses, hospitalization and surgical expenses. It also provides hospital cash benefit and recuperation benefit.

3: Wellsurance Family: Wellsurance Family is a single policy for the entire family. It is unique combination of health insurance and Wellness offers. The policy covers critical illnesses and provides hospital cash, recuperation benefits and child education benefits, all in one policy.

4: Wellsurance Woman: Wellsurance Woman is a tailor made health insurance plan for women and covers critical illnesses with higher cancer cover. The policy offers hospital cash benefits, recuperation benefits, and cosmetic reconstructive surgery benefits all in one policy.

5: MediSenior: Medisenior policy is made exclusively for the elderly offering health cover and ensuring policyholder and his or her spouse has the best medical treatment and financial backup in the sunset years of life.

6: MediRaksha: MediRaksha is an affordable health insurance plan tailor made as a cost effective health cover for the entire family. The plan comes with a family discount of 10%, if 2 or more members of a family are covered under the same policy on Individual sum insured basis.

7: MediPlus: This is a top-up plan providing extra coverage for your family to lead a relaxed carefree life. Mediplus Top-up plan buffers against any unforeseen medical situations and rising medical and healthcare costs.

8: Critical Illness Policy: Critical illness policy is a unique policy which provides coverage for critical illness. it also provides a second opinion benefit if the insured person has been diagnosed with any one of the 11 covered critical illnesses defined in the policy.

Tata AIG Health Insurance Plans in detail
1: MediPrime:
MediPrime Health Insurance Policy Features Details
Entry age 5-65 years (Dependent children between 91 days and 5 years can be insured only when both parents are getting insured)
Sum Insured Options Rs. 200,000; Rs. 300,000; Rs. 400,000; Rs. 500,000; Rs. 750,000; Rs. 1,000,000
Cumulative Bonus Cumulative Bonus of 10% of the Sum Insured for every claim free year accumulating up to 50%.
Health Check-up 1% of the Sum Insured per Policy subject to a maximum of Rs. 5,000 per Insured Person only once at the end of a block of every continuous four claim free years.
Policy period 1 Year and 2 years
Maximum Age There is no maximum cover ceasing under this policy.
Coverage options Family Floater Basis (where family includes spouse, dependent children and dependent parent)
Tax Benefit The premium amount paid under this policy qualifies for deduction under Section 80D of the Income Tax Act.

Inclusions, Benefits and Features
  • In-patient Treatment– Covers hospitalization expenses due to an illness or accident. Policy pays for the medical expenses for Room rent, boarding expenses, Nursing, Intensive care unit, Medical Practitioner(s) etc.
  • Pre-Hospitalisation- The Medical Expenses incurred in 30 days immediately before the Insured Person was hospitalized. It can be increased to 60 days if claim is intimated 5 days before hospitalization.
  • Post-Hospitalization - The Medical Expenses incurred in the 60 days immediately after the Insured Person was discharged post hospitalization. It can be increased to 90 days if claim is intimated 5 days before hospitalization.
  • Day Care Procedures–The Medical expenses for 140 Day care procedures which do not require 24 hours hospitalization due to technological advancement.
  • Domiciliary Treatment - The Medical Expenses incurred by an Insured Person for availing medical treatment at his home which would otherwise have required hospitalization.
  • Organ Donor-The Medical Expenses on harvesting the organ from the donor for organ transplantation.
  • Emergency Ambulance– Expenses Up to Rs. 2,500 per hospitalization for utilizing ambulance service for transporting Insured Person to Hospital in case of an emergency.
  • Ayush Benefit – Covers Medical Expenses incurred for In-patient treatment taken under Ayurveda, Unani, Sidha or Homeopathy.
  • Daily Cash for Accompanying an Insured Child - If the Insured person hospitalized is a child Aged 12 years or less, a daily cash amount for 1 accompanying adult for each complete period of 24 hours is paid if hospitalization exceeds 72 hours.
Medi Prime – Schedule of Benefits
Sum Insured per Policy per Policy Year (Rs. in Lacs) 2.00, 3.00, 4.00 5.00, 7.50, 10.0
1 a) In-patient Treatment Covered Covered
1 b) Pre-hospitalization Covered Covered
1 c) Post-hospitalization Covered Covered
1 d) Day Care Procedures Covered Covered
1 e) Domiciliary Treatment Covered Covered
1 f) Organ Donor Expenses Covered Covered
1 g) Emergency Ambulance Up to Rs. 2,500 per hospitalisation Up to Rs. 2,500 per hospitalisation
1 h) Dental Treatment (In case of Accident) Inpatient Dental treatment – Up to Inpatient Sum Insured. Outpatient Dental treatment – Up to Rs. 5,000. Inpatient Dental treatment – Up to Inpatient Sum Insured. Outpatient Dental treatment – Up to Rs. 7,500.
1 i) Ayush Benefit Inpatient Ayurveda, Unani, Sidha or Homeopathy treatment maximum Up to Rs. 20,000 Inpatient Ayurveda, Unani, Sidha or Homeopathy treatment maximum Up to Rs. 25,000
1 j) Daily Cash for accompanying an Insured Child Rs. 300 per day, maximum Up to Rs. 9,000 Rs. 500 per day, maximum Up to Rs. 15,000
1k) Vaccination (In case of post-bite treatment) Inpatient treatment – Up to In-patient Treatment Sum Insured. Outpatient Vaccination - Up to Rs. 5,000 Inpatient treatment – Up to In-patient Treatment Sum Insured. Outpatient Vaccination - Up to Rs. 5,000
2) Health Check-up 1% of the Sum Insured per Policy subject to a maximum of Rs. 5,000 per Insured Person only once at the end of a block of every continuous four claim free years 1% of the Sum Insured per Policy subject to a maximum of Rs. 5,000 per Insured Person only once at the end of a block of every continuous four claim free years

2: Wellsurance Executive
Wellsurance Executive Health Insurance Policy Features Details
Entry age 18 to 65 years.
Coverage Critical Illness, In hospital benefit for Sickness, In hospital benefit for Accident, Major Surgical Benefit and Minor Surgical Benefit
Renewability Renewable for life
Payout Basis Fixed amount on the occurrence of a covered event
Tax Benefits Avail benefit for premium paid on policies as per section 80D of the Income Tax Act.
Grace Period 30 days
Free Look period 15 days

Inclusions, Benefits and Features
  • Critical Illness Benefits - Critical Illness benefits are available on diagnosis of specified Critical illnesses without hospitalization of the insured. This benefit will be paid without any conditions as how the money would be spent by you
  • Hospitalization - Hospitalization benefits including major and minor surgeries will be payable on hospitalization as per the limits specified in the policy schedule.
  • Hospital Cash benefits - Hospital Cash benefits are payable basis the number of days the insured is hospitalized. These benefits take care of the incidental expenses incurred during hospitalization. This benefit will be paid, regardless of the expenses incurred.
  • Post Hospitalization Expenses: Pays lump sum amount after hospitalization under post operative physiotherapy (eligibility minimum of 2 visits), chemotherapy and/or radiation (eligibility minimum of 3 visits) payable once during the lifetime of the insured and Kidney dialysis- payable once during the lifetime of the insured.
  • Value added service: Facilities like free health line, health portal, health query, discounted services for the health and wellness and e-news letter will be provided to the insured where he will get access to various health articles and will be able to raise queries and get them answered by experts.
  • Convalescence Benefit: Pays lump sum amount for the recovery at home, immediately following hospital discharge as an inpatient for a minimum hospitalisation of 5 consecutive nights.
  • Ambulance Benefits: Pays up to the specified amount towards the medical transportation fees and services incurred for bringing the insured to the hospital following an accident and returning to the normal place of residence after being discharged from the hospital.
Exclusions
  • Any pre-existing condition will have a waiting period of 4 years from the date of policy inception.
  • Any critical illness signs/symptoms of which first occurred prior to or within the waiting period (90 days)
  • AIDS, HIV infection or sexually transmitted condition, congenital anomalies or complications, pregnancy or child birth related treatments
  • Any ayurvedic, homeopath or naturopath treatments, weight control programs
  • Medical expenses as a result of alcohol and/or drug abuse, addiction or overdose as well as intentional self injury
  • War, civil war, invasion, hostilities, nuclear weapon induced hospitalization, professional sports, hazardous activities
  • Elective, cosmetic or plastic surgery, except as a result of an Injury caused by a covered Accident while the policy is in force;
  • Any mental, nervous disorders, anxiety, stress or depression.

3: Wellsurance Family
Wellsurance Family Health Insurance Policy Features Details
Entry age 18 to 65 years.
Premium Payment Calculation Premium is calculated as per the age of the eldest member covered in the policy
Cover Critical Illness, In hospital benefit for Sickness, In hospital benefit for Accident, Major Surgical Benefit and Minor Surgical Benefit
Renewability Renewable for life
Payout Basis Fixed amount on the occurrence of a covered event
Tax Benefits Benefit for premium paid on policies as per section 80D of the Income Tax Act.
Grace Period 30 days
Free Look period 15 days

Inclusions, Benefits and Features
  • Critical Illness Benefits: Lump sum payment provided if the insured person is diagnosed as suffering from the specified critical illness. Signs and symptoms of the critical illness should be after 90 days from the policy inception date and insured has to survive the critical illness by 30 days or more from the date of diagnosis.
  • Intensive care unit benefit: Policy pays a daily benefit for each day you are an inpatient admitted in the intensive care unit in a hospital due to injury/sickness.
  • Ease of hospitalisation: When a family member is admitted to the hospital for an illness or injury, policy provides them with a daily cash allowance for up to 90 days.
  • Ambulance Charges: Pays up to the specified amount towards the medical transportation fees and services incurred for bringing the insured to the hospital following an accident.
  • Value added service: Facilities like free health line, health portal, health query, discounted services for the health and wellness and e-news letter will be provided to the insured where he will get access to various health articles and will be able to raise queries and get them answered by experts.
  • Convalescence Benefits: Pays lump sum as the sum insured shown in the policy schedule of cover, for the recovery at home, immediately following hospital discharge as an inpatient for a minimum hospitalisation of 5 consecutive nights.
  • Education Benefit: The policy pays the sum insured schedule if the principal insured suffers accidental death or permanent total disability
Exclusions
  • Any pre-existing condition will have a waiting period of 4 years from the date of policy inception.
  • Any critical illness signs/symptoms of which first occurred prior to or within the waiting period (90 days)
  • AIDS, HIV infection or sexually transmitted condition, congenital anomalies or complications, pregnancy or child birth related treatments
  • Any ayurvedic, homeopath or naturopath treatments, weight control programs
  • Medical expenses as a result of alcohol and/or drug abuse, addiction or overdose as well as intentional self injury
  • War, civil war, invasion, hostilities, nuclear weapon induced hospitalization, professional sports, hazardous activities
  • Elective, cosmetic or plastic surgery, except as a result of an Injury caused by a covered Accident while the policy is in force;
  • Any mental, nervous disorders, anxiety, stress or depression.

4: Wellsurance Woman
Wellsurance Woman Health Insurance Policy Features Details
Entry age 18 to 65 years.
Renewability Renewable for life
Payout Basis Fixed amount on the occurrence of a covered event
Tax Benefits Benefit for premium paid on policies as per section 80D of the Income Tax Act.
Grace Period 30 days
Free Look period 15 days

Covered Critical Illnesses: The Critical Illness Benefit covers any of the following illnesses upon diagnosis being:

  • C1) Cancer of specified severity
  • C2) First Heart Attack of specified severity
  • C3) Stroke resulting in permanent symptoms
  • C4) Kidney Failure requiring regular dialysis
  • C5) Coma of specified severity
  • C6) Total Blindness (due to acute sickness or accident)
  • C7) Major Burns
  • C8) Multiple Sclerosis with persisting symptoms
  • C9) Permanent Paralysis of Limbs
  • C10) Open Chest CABG
  • C11) Major Organ /Bone Marrow Transplant
Inclusions, Benefits and Features
  • Critical Illness Benefits: Lump sum payment shall be provided if the insured person is diagnosed as suffering from the specified critical illness for the first time during policy period. Signs and symptoms of the critical illness should be after 90 days from the policy inception date and insured has to survive the critical illness by 30 days or more from the date of diagnosis.
  • Hospital Cash benefits - Hospital Cash benefits are payable basis the number of days the insured is hospitalized. These benefits are paid regardless of the expenses incurred.
  • Intensive care unit benefit: The policy pays a daily benefit for each day you are an inpatient admitted in the intensive care unit in a hospital due to injury/sickness.
  • Cosmetic Reconstruction Surgery: Pays the specified amount if the surgery is conducted as a reconstructive procedure on structures of the body for the purpose of the restoring/improving bodily function or correcting significant deformity resulting from accidental injury as covered under the hazard, subject to the maximum shown in the policy schedule.
  • Value added service: Facilities like free health line, health portal, health query, discounted services for the health and wellness and e-news letter will be provided to the insured where he will get access to various health articles and will be able to raise queries and get them answered by experts.
Exclusions
  • Any pre-existing condition will have a waiting period of 4 years from the date of policy inception.
  • Any critical illness signs/symptoms of which first occurred prior to or within the waiting period (90 days)
  • AIDS, HIV infection or sexually transmitted condition, congenital anomalies or complications, pregnancy or child birth related treatments
  • Any ayurvedic, homeopath or naturopath treatments, weight control programs
  • Medical expenses as a result of alcohol and/or drug abuse, addiction or overdose as well as intentional self injury
  • War, civil war, invasion, hostilities, nuclear weapon induced hospitalization, professional sports, hazardous activities
  • Elective, cosmetic or plastic surgery, except as a result of an Injury caused by a covered Accident while the policy is in force;
  • Any mental, nervous disorders, anxiety, stress or depression.

5: MediSenior
Health Insurance Policy Features Details
Entry age 61 years and above
Max Age No maximum cover ceasing age
Policy Tenure 1 year or 2 years
Policy Coverage Policy can be issued to an individual and/or family on individual sum insured basis. The family includes self and spouse only.
Premium Discount 7.5% Discount on premium if Insured Person pays premium of 2 years in advance
Sum Insured per Insured Person per Policy Year (Rs. in Lakh) 2.00, 3.00, 5.00
In-patient Treatment Covered
Pre-Hospitalization Covered up to 30 days
Post-Hospitalization Covered up to 60 days
Day Care Procedures Covered for 140 Day Care procedures
Domiciliary Treatment Covered
Organ Donor Covered
Emergency Ambulance Up to Rs. 2000 per hospitalization

Inclusions, Benefits and Features
  • Wide network of hospitals: If you are above 61 years, then you can purchase this policy which covers a network of over 3,000+ hospitals.
  • Discounts: You can avail a 7.5% discount on your policy premium if you pre-pay the premium of two years. You also get a 5% family discount if two family members are covered under the Medisenior policy.
  • In-patient Treatment- Covers hospitalization expenses in a shared accommodation for period more than 24 hrs.
  • Pre-Hospitalization - Medical expenses incurred in 30 days before the hospitalization.
  • Post-Hospitalization - Medical expenses incurred in 60 days after the hospitalization.
  • Day care procedures: Avail coverage for up to 140 days for care procedures that do not need hospitalisation.
  • Policy flexibility: You can renew your Medisenior policy lifelong and even increase your sum assured while enjoying hassle-free claim settlement.
  • Domiciliary Treatment- Medical expenses incurred for availing medical treatment at home which would otherwise have required hospitalization.
  • Organ Donor- Medical expenses on harvesting the organ from the donor for organ transplantation.
  • Emergency Ambulance- Actual expenses incurred or Rs. 2,000 whichever is lower per hospitalization for utilizing ambulance service for transporting insured person to hospital in case of an emergency.
  • Co-Payment applicable on accommodation type: Shared Accommodation or any lower accommodation type - 15%, single occupancy or any higher accommodation type- 30%.
  • No Claim Discount - A 5% non cumulative discount offered on the renewal premium payable under the Policy after every claim free policy year, provided that the Policy is renewed with Us and without a break.
  • Free Look Period- You have a period of 15 days from the date of receipt of the Policy document to review the terms and conditions of this Policy.
Exclusions
  • In case of self-inflicted injury or illness.
  • There are conditions related to HIV/AIDS.
  • There’s a war or exposure to toxic or radioactive substances.
  • You suffer from any congenital anomalies.
  • You indulge in drug or alcohol abuse.

6: MediRaksha
Health Insurance Policy Features Details
Entry age 91 days and beyond
Maximum age 65 years
Policy period 1 or 2 year(s)
Coverage options Individual sum insured basis only. This policy can be issued to an individual and/or family. The family includes spouse, Dependent children and dependent parent(s).
Child Cover Dependent child aged between 91 days to 21 years if they are unmarried are covered. Dependent Child between 91 days and 5 years can be insured only when both parents are getting insured.
Sum Insured Rs. 50,000/- ; Rs. 75,000/- Rs. 1, 00,000 on Individual basis only. The sum insured is non Cumulative.
Discounts on Premium
  • A family discount of 10%, if 2 or more members of a family are covered under the same policy on Individual sum insured basis.
  • 7.5% Discount on premium if Insured Person is paying premium of 2 years in advance.

Inclusions, Benefits and Features
  • In-patient treatment: The policy covers the costs of hospitalization due to illness or an accident. The covered expenses include room rent, boarding, ICU, and nursing. You also receive coverage for medicines, drugs and other consumables.
  • Relaxed medical tests requirements: No need to undergo medical tests until the age of 55.
  • More coverage, greater security: This policy extends coverage to seven family members. That means besides yourself, you can secure your spouse, parents, and three children too.
  • Organ donor: The policy also covers the costs of an organ transplant – both for the organ receiver and the donor in the harvesting stage.
  • Day-care procedures: Medical expenses for 144 day care procedures if treatment is taken as in-patient in hospital or stand alone day care centre for which hospitalization required is less than 24 hours.
  • Prepay Discount: If you prepay your policy premium of two years, then you can avail a 7.5% discount on premium.
  • Save money: You get a 10% discount if you cover your whole family.
  • Pre-hospitalisation and post-hospitalisation: All your medical expenses arising up to 30 days prior to and up to 60 days after the hospitalisation will be taken care of by the policy.
  • Health check-up: You are eligible for a health check-up after four claim-free years. The policy will pay for the expenses of up to 1% of the sum assured or Rs 1,000, whichever is lower.
  • Flexibility: Besides easy portability, lifelong renewability, enhancement of sum assured, you also have the option of purchasing this policy for two years.
Exclusions
  • Drug or alcohol abuse.
  • Any pre-existing disease and any complication arising from the same.
  • Self-inflicted injury or illness.
  • Conditions related to HIV/AIDS.
  • War or exposure to toxic or radioactive substances.
  • Any congenital medical conditions, pregnancy and/all related conditions.

7: MediPlus
Health Insurance Policy Features Details
Entry age 91 days
Maximum age 65 years
Policy period 1 year, 2 year(s)
Coverage options The policy offers coverage on individual sum insured basis. This policy can be issued to an individual and/or family.
Free Look Period 15 days
Premium Discounts
  • Family Discount of 10% if 2 or more family members are covered under same policy.
  • 7.5% Discount on premium if Insured Person is paying premium of 2 years in advance.
Renewability no maximum cover ceasing age

Inclusions, Benefits and Features
  • Cover up to7 people: You can buy a single policy that covers you, your spouse, three children, and your parents. It covers everyone from a 91-day-old baby to those who are 65 years old.
  • In-patient Treatment– Medical Expenses for hospitalization above 24 hrs.
  • Pre-Hospitalization -Medical Expenses incurred in 60 days before the admission in the Hospital.
  • Post-Hospitalization -Medical Expenses incurred in 90 days after the discharge from Hospital.
  • Day-Care procedures – Medical Expenses for enlisted 140 Day care procedures
  • Organ Donor- Medical Expenses on harvesting the organ from the donor for organ transplantation.
  • Emergency Ambulance– Actual expenses incurred or Rs. 2,000 whichever is lower per hospitalization for utilizing ambulance service for transporting Insured Person to Hospital in case of an Emergency.
  • Domiciliary Treatment - The Medical Expenses incurred by an Insured Person for availing medical treatment at his home which would otherwise have required hospitalization.
  • Premium Discounts: You pay 10% less premium if you cover two or more family members with the policy. And if you opt for a 2-year policy, you can avail another 7.5% discount.
Exclusions
  • Drug or alcohol abuse.
  • Any pre-existing disease and any complication arising from the same.
  • Self-inflicted injury or illness.
  • Conditions related to HIV/AIDS.
  • War or exposure to toxic or radioactive substances.
  • Any congenital medical conditions, pregnancy and/all related conditions.

8: Critical Illness Policy
Inclusions, Benefits and Features
  • Receive coverage amount in a lump-sum.
  • ‘Sum Insured Enhancement’ feature allows increase on Sum assured during policy renewal.
  • Tax benefits: Reduce your taxable income by up to Rs 50,000 through our critical illness cover.
  • Critical Illness Benefits: The Critical Illness Benefit covers any of the following illnesses upon diagnosis being:
  • First Heart Attack - of specified severity
  • Cancer of specified severity
  • Stroke resulting in Permanent Symptoms
  • Open Chest CABG
  • Kidney Failure Requiring Regular Dialysis
  • Major Organ / Bone Marrow Transplant
  • Total Blindness
  • Coma of specified severity
  • Major Burns
  • Multiple Sclerosis with persisting symptoms
  • Permanent Paralysis of Limbs
  • Second Opinion Benefit: The second opinion benefit is valid only if your Critical Illness Insurance Policy is in force and the Insured Person has been diagnosed with any one of the 11 Covered Critical Illnesses defined in this policy.
Exclusions
  • Your diagnosis took place before buying the policy or during the 30-day waiting period.
  • You suffer from a medical condition that is not part of the 12 illnesses covered.
  • There are issues related to pre-existing diseases, congenital medical conditions, and/or pregnancy.
  • You suffer from self-inflicted injury or illness and suicide, sexually transmitted conditions and HIV/AIDS
  • There’s a war or exposure to toxic or radioactive substances.
  • You apply for a claim for non-critical illness as well as optional treatments like cosmetic or bariatric surgery.
  • You suffer any injury or accident while being involved in adventure sports activities like skydiving and racing.

Tata AIG Health Insurance Exclusions:
While exact nature of exclusions varies for every health insurance policy offered by TATA AIG health insurance here are some common exclusions in all health insurance plans.
  • Any pre-existing condition will have a waiting period of 4 years from the date of policy inception.
  • Any critical illness signs/symptoms of which first occurred prior to or within the waiting period (90 days)
  • AIDS, HIV infection or sexually transmitted condition, congenital anomalies or complications, pregnancy or child birth related treatments
  • Medical expenses as a result of alcohol and/or drug abuse, addiction or overdose as well as intentional self injury
  • War, civil war, invasion, hostilities, nuclear weapon induced hospitalization, professional sports, hazardous activities
  • Elective, cosmetic or plastic surgery, except as a result of an Injury caused by a covered Accident while the policy is in force;
  • Any mental, nervous disorders, anxiety, stress or depression.

Tata AIG Health Insurance Login:
TATA AIG offers a single online platform which allows all users to seek extensive details of all their health insurance plans. The customer portal at https://www.tataaiginsurance.in/cpanel/ login.jsp offers the option for:
  • Viewing policy details: Get the complete details of all your existing policies
  • Viewing policy history: Get a complete history of all your transactions and claims across policies.
  • Register an online claim request
  • Request policy document on email.

Tata AIG Health Insurance Renewal:
  • Sign up and log into the Tata AIG Health Insurance customer portal and choose the policy to be renewed by clicking on the relevant listed policy at https://www.tataaiginsurance.in/cpanel/ login.jsp
  • Renewals can also be made offline by calling TATA AIG health insurance on their toll free 1800-266-7780 or by mailing or delivering the cheque for renewal to their nearest branch.

Tata AIG Health Insurance Claim Settlement:
TATA AIG health insurance policyholders can register for their claim settlement by visiting the customer portal and requesting for a claim for reimbursement claims at https://www.tataaiginsurance.in/cpanel/ login.jsp. Alternatively policyholder can also fill up their claim requests online by visiting https://www.tataaig.com/claimregister

Policyholders can also call the toll free number at 1800-266-7780 or send a SMS by typing claims and sending it to 5616181 to receive a call back from TATA AIG in a maximum time frame of 1 hour.

Cashless Claim Reimbursement Claim
The insured approaches any of the networked hospital with TATA AIG for cashless treatment. The insured collects all hospitalization documents and submit the same with TATA AIG health insurance.
The TPA helps the customer by verifying customer details and sending the preauthorization form for approval. TATA AIG conducts a preliminary scrutiny for claims and verifies policy benefits and requisite documentation.
Once approved the Authorization letter is sent to the provider for go ahead. Once TATA AIG receives all the required documents from the Insured and the claim is approved, the claim gets settled within 7 working days.
Hospital treats the patient without any deposit till discharge once approved.  

Tata AIG Health Insurance FAQs:
1: Where can I find details of all approved agents for TATA AIG health insurance?
The list of all TATA AIG health insurance agents including their status and agent codes is available online at https://www.tataaig.com/content/dam/ tagic/PDF/AgentLists/ List_Of_Individual_Agents_TAGIC_ Oct%2017.pdf

2: Does TATA AIG health insurance offer any critical illness plan?
Yes you can opt for Critical Illness Policy by TATA AIG with UIN: IRDA/NL-HLT/TAGI/P-H(C)/V.I/299/13-14. The policy covers 11 Critical Illnesses along with a second opinion benefit.

3: Are day care treatments covered by TATA AIG health insurance for senior citizen?
Coverage for day care treatment depends on the policy terms and conditions. For senior citizens, TATA AIG offers its MediSenior health insurance plan which offers day care treatment coverage for over 140 diseases.

4: Will TATA AIG MediPrime policy offer protection if I choose to seek naturopathy treatment instead of allopathic?
TATA AIG Mediprime offers cover for Ayush benefit with coverage for Non-allopathic in-patient treatments like Ayurvedic, Unani or Homeopathy up to a maximum limit of Rs. 20,000

5: What is sublimit in TATA AIG health insurance plan?
Sublimit is the limitation in an insurance policy on the amount of coverage available to cover a specific type of expenditure. It can be in amount or percentage.

6: Who is a TPA?
Third Party Administrators are authorized claim settling agents of the Insurer who ensure that the policy terms and conditions are complied to.

7: Can TATA AIG help me choose the right health insurance plan for my needs?
You can seek the help of TATA AIG expert insurance advisors available at https://www.tataaig.com/about-us/ask-expert to help you choose the best plans.

8: How to find the nearest TATA AIG branch near me?
You can make use of the TATA AIG branch locater tool available at https://www.tataaig.com/branch-locator and find out the details of your nearest TATA AIG general insurance office.

9: Are cashless claims available across India for TATA AIG health insurance?
Cashless claims facility is available at over 3000+ Network hospitals across India.

10: Where can I get the claim form for reimbursement?
TATA AIG health insurance policyholders can register for their claim settlement by visiting the customer portal and requesting for a claim for reimbursement claims at https://www.tataaiginsurance.in/ cpanel/login.jsp. Policyholders can also call the toll free number at 1800-266-7780 or send SMS by typing claims and sending it to 5616181.

11: What is the list of documentation to be submitted while claiming a TATA AIG health insurance hospitalization claim?
The lists of documents to be submitted include the duly signed claim form, original discharge summary, original hospital bill and paid receipts. All Lab and test reports, fully filled NEFT details form, the first consultation letter from doctor and KYC details.